title: Distribution of 13-valent pneumococcal conjugate vaccine Streptococcus pneumoniae serotypes in US adults aged ≥50 years with community-acquired pneumonia.
abstract: BACKGROUND
  Streptococcus pneumoniae causes a substantial proportion of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) in the United States. Limited data are available regarding the pneumococcal serotypes causing CAP and HCAP.
  
  
  METHODS
  Adults aged ≥ 50 years presenting to participating US hospitals with radiographically confirmed pneumonia between February 2010 and September 2011 were screened for inclusion. S. pneumoniae was identified using microbiological cultures, BinaxNOW® S. pneumoniae assay, or urine antigen detection (UAD) assay capable of detecting 13-valent pneumococcal conjugate vaccine (PCV13)-associated serotypes.
  
  
  RESULTS
  Among 710 subjects enrolled, the median age was 65.4 years; 54.2% of subjects were male, 22.4% of radiographically confirmed pneumonia cases were considered HCAP, and 96.6% of subjects were hospitalized. S. pneumoniae was detected in 98 subjects (13.8%) by any test, and PCV13-associated serotype(s) were identified by UAD in 78 (11.0%). Serotype 19A was most prevalent, followed by 7F/A, 3, and 5. Serotypes associated with 7-valent pneumococcal conjugate vaccine (PCV7) accounted for 25% of UAD-positive isolates.
  
  
  CONCLUSIONS
  Pneumococcal serotypes causing noninvasive pneumonia in adults may differ significantly from those causing invasive disease, with PCV7-associated serotypes overrepresented. Serotype 5, rarely seen in contemporary surveillance of invasive disease in the United States, substantially contributed to the observed cases of S. pneumoniae-positive CAP or HCAP.
authors.affiliation: Sinai Grace Hospital Emergency Department and Sinai Grace Hospital/Detroit Receiving Hospital, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sherwin
authors.forename: Sharon
authors.initials: S
authors.lastname: Gray
authors.forename: Ronika
authors.initials: R
authors.lastname: Alexander
authors.forename: Paul C
authors.initials: PC
authors.lastname: McGovern
authors.forename: Jay
authors.initials: J
authors.lastname: Graepel
authors.forename: Michael W
authors.initials: MW
authors.lastname: Pride
authors.forename: Jay
authors.initials: J
authors.lastname: Purdy
authors.forename: Peter
authors.initials: P
authors.lastname: Paradiso
authors.forename: Thomas M
authors.initials: TM
authors.lastname: File
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology* / Q000517:prevention & control; D003428:Cross Infection; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011134:Polysaccharides; D015995:Prevalence; D011446:Prospective Studies; D012703:Serotyping; D013045:Species Specificity; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology*; D014481:United States / Q000453:epidemiology; D018074:Vaccines, Conjugate / Q000276:immunology
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines; D011134:Polysaccharides; D018074:Vaccines, Conjugate
keywords: 13-valent pneumococcal conjugate vaccine; Streptococcus pneumoniae; community-acquired pneumonia; healthcare-associated pneumonia; pneumococcal serotypes; serotype distribution; urinary antigen detection assay